# Molecular Hydrogen Therapy in Sjögren's Syndrome With Pulmonary Arterial Hypertension and Right-sided Heart Failure: A Case Report of Improved Immune Markers Including Treg, B Cells and Plasma Cell.
> シェーグレン症候群に伴う肺動脈性肺高血圧症および右心不全における分子状水素の免疫マーカー（Treg・B細胞・形質細胞）への影響：症例報告


## Abstract

A 56-year-old woman with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) secondary to Sjögren's syndrome, complicated by interstitial lung disease, experienced progressive deterioration including cardiogenic shock in 2020 despite multiple pharmacological agents (sildenafil, bosentan, macitentan, iloprost, and corticosteroids). Beginning in May 2023, oral hydrogen capsules were introduced as an adjunctive measure. Follow-up assessments revealed an increase in CD127+ regulatory T cells, a reduction in anti-Ro antibody levels, and decreases in B cell subsets. Clinical symptoms stabilized over the observation period with no adverse events recorded. The findings suggest that molecular hydrogen may exert anti-inflammatory and immunomodulatory effects relevant to CTD-PAH, though larger studies are required to confirm these observations.

### Mechanism

Molecular hydrogen is proposed to exert anti-inflammatory and immunomodulatory effects, increasing CD127+ regulatory T cells while reducing anti-Ro antibody titers and B cell subsets, thereby improving the overall immune cell profile in CTD-PAH.

## Bibliographic

- **Authors**: Lin Y, Lu J, Wu CY, Ho YJ, Lui SW, Hsieh TY, et al.
- **Journal**: In Vivo
- **Year**: 2024
- **PMID**: [39477378](https://pubmed.ncbi.nlm.nih.gov/39477378/)
- **DOI**: [10.21873/invivo.13797](https://doi.org/10.21873/invivo.13797)
- **PMC**: [PMC11535911](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535911/)
- **Study type**: human case report
- **Delivery route**: hydrogen-rich water
- **Effect reported**: positive

## Delivery context

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

## Safety notes

Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)
- [Inhalation safety threshold lineage](https://h2-papers.org/en/safety-notes/lineage)

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> **Cite as**: H2 Papers — PMID 39477378. https://h2-papers.org/en/papers/39477378
> **Source**: PubMed PMID [39477378](https://pubmed.ncbi.nlm.nih.gov/39477378/)